Ce modèle de relevé d'informations aide à préparer une visite technique de rénovation énergétique. Il couvre les données propriétaire et logement, l'année de construction, combles et plancher bas, isolation des murs et menuiseries, types de vitrage, énergie de chauffage (électrique, bois, gaz, PAC, fioul, réseau), production d'eau chaude, surface et hauteur de pièce, photos, ainsi que les problèmes d'aération. Des champs pour le nombre de personnes au foyer et le revenu fiscal permettent d'évaluer l'éligibilité aux aides.
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